Gerontological Research Research Articles

PUBLISHING ON A GLOBAL SCALE IN GERONTOLOGY: A VIEW FROM THE EDITORS’ DESKS

Abstract Global aging has proceeded at an unprecedented and accelerating rate. The aging of the population creates both opportunities and challenges for older adults, their families, and society. Importantly, there is substantial variation in the effects of and response to global aging both within and across nations depending, in part, on prevailing cultural expectations and values, political and economic imperatives, and social and demographic characteristics. Thus, while some regions and countries have responded with innovative policies and programs to better enable the growing cohort of older adults to remain active and engaged in the community, other regions and countries have struggled with their response or barely begun to plan for the rising population of older adults. This symposium assembles editors at five leading gerontological journals to demonstrate the role that peer-reviewed scholarship can play in disseminating knowledge that informs gerontological research, policy, and practice internationally. The editors include: Edward Alan Miller, PhD, Journal of Aging & Social Policy; Kyungmin Kim, PhD, Research on Aging; Julie Robison, PhD and Debra Dobbs, PhD, Journal of Applied Gerontology; Julie Patrick, PhD, International Journal of Aging and Human Development; and Sandra Torres, PhD, Ageing & Society. Each presenter will review the scope, content, and focus of their journals and the role and opportunities for international scholarship. Nicholas Castle, PhD, International Editor at The Gerontologist, will serve as discussant.

PROMOTING MENTAL HEALTH LITERACY AMONG OLDER ADULTS IN THE EAST: AN INTEGRATIVE FRAMEWORK

Abstract Although mental health literacy is of considerable importance to advance the welfare of older adults, previous research has shown that the public has a poor understanding of mental health and recognition of mental health symptoms. Traditional mental health literacy promotion programmes utilized a top-down approach; no bottom-up model had been used. Moreover, the existing participatory research paradigms were developed in the West and might not be applicable in the East, given different socioeconomic and cultural contexts. This research aimed to fill the gap by co-creating an integrative framework with stakeholders to promote mental health literacy among older adults in the East using a community-based participatory approach as a case illustration. We conducted a mental health literacy promotion pilot project in five Hong Kong districts from May 2021 to August 2023, spanning over 2 years. Each district formed an action committee, which comprised 5-10 community older adults and 2 social workers, and 2 researchers. Each district had its own promotional activities initiated and designed by older adults, including street booths, art workshops, and publicity materials to promote mental health and introduce relevant information and resources. We conducted six focus groups (n=25) with stakeholders, and we recorded our experiences on reflection notes. Collected data suggested specific elements are important for an integrative framework in the East, including participant empowerment, stakeholders’ role and expectation management, and potential community contribution. We advance gerontological research and practice by providing an integrative framework to promote mental health literacy in the East. Implications will be discussed further.

EXPANDING EDUCATIONAL OPPORTUNITIES IN GERONTOLOGY IN JAPAN

Abstract There are two universities that offer Gerontology curriculum and confer Gerontology degrees in Japan, including J.F. Oberlin University and The University of Tokyo. J.F. Oberlin University started its Master’s program in 2002 and its doctoral program in 2004. The University of Tokyo endowed a Gerontology Research Division in 2006 and started its cross-departmental program in Gerontology in 2008. The endowed Gerontology Research Division was elevated to the Institute of Gerontology (IOG) in 2009. From April 2014 through March 2021, the Gerontology program, known as the Global Leadership Initiative for Age-Friendly Society (GLAFS) at The University of Tokyo, was funded by the Ministry of Education, Culture, Sports, Science and Technology. Today, The University of Tokyo now funds the program which was renamed World-leading Innovative Graduate Study Program in Gerontology: Global Leadership Initiative for Age-Friendly Society (WINGS-GLAFS). This paper first presents a brief history of Gerontology-related events in Japan, including foundational education proposals of The Science Council of Japan, then introduces Japan’s leading Gerontology education programs offered by J.F. Oberlin University and The University of Tokyo in detail. Finally, it presents other gerontology related activities including the Gerontology Literacy Test started by the IOG in 2013.

EMBRACING THE QUEER ART OF FAILURE IN GERONTOLOGICAL RESEARCH AND EDUCATION

Abstract Halberstam describes the queer art of failure as a performance of dissidence in which lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) people willing reject traditional conceptualizations of success. Yet, dominant theoretical frameworks in gerontology are predicated upon notions of success and productivity which may be problematic for understanding the life trajectories of LGBTQ+ people. The use of such heteronormative frameworks has implications for gerontological research in two important ways: 1) Research methods and researchers themselves may be constrained by the normative expectations placed on LGBTQ+ people and 2) Heteronormative frameworks obscure the nuance of LGBTQ+ older adults’ lived experiences and may limit important contributions to gerontological knowledge. This symposium applies the queer art of failure to examine LGBTQ+ aging scholarship that deviates from traditional research and education. Speaker one shares experiences from LGBTQ+ individuals facing dementia, using concepts that counter framing dementia as pathology and decline. Speaker two discusses how participants’ preferences for receiving research results via found poetry may reflect LGBTQ+ participants’ natural inclination to question hegemonic norms. Speaker three describes collaborating with a coalition of LGBTQ+ older adults of color on a participatory action research study, detailing how epistemic tensions shaped the research in unexpected ways. Speaker four discusses how institutional failure led to enthusiasm for LGBTQ+ curriculum development, student mentoring, and knowledge production. These presentations suggest that the inclusion of diverse conceptualizations of success and productivity should inform future aging scholarship, as they may center the experiences of historically marginalized populations such as LGBTQ+ older adults.

CHALLENGES AND CONSIDERATIONS IN RESEARCH WITH OLDER ADULTS EXPERIENCING HOMELESSNESS

Abstract Individuals in their late 50s and 60s constitute the fastest growing cohort of homeless adults; homelessness among the older adult population is expected to triple by 2030 (Culhane et al., 2019). Older adults find themselves homeless due to systemic (e.g., unaffordable housing, structural racism, increasing healthcare costs) and individual factors (e.g., substance misuse, mental health diagnoses). Unhoused older adults have high rates of multiple chronic conditions (Henwood et al., 2018) worsened by unmet healthcare needs (Baggett et al., 2010). Older adults, especially those with serious illness, struggle to find and maintain housing compared to younger adults without illness. Patient and clinician-informed services/programs are needed, but the nature of serious illness and homelessness research comes with unique considerations. Research challenges in this population include inclusive and adequate recruitment, participant screening, and boundary issues (Hanson et al., 2014; Lashley, 2023). We will present lessons learned from completing two successful qualitative studies with unhoused older adults and clinical subject groups. Issues encountered during our research include dealing with recruitment obstacles, evaluating and responding to participants’ cognitive impairment and mental health issues, managing emotional labor experienced by the research team, developing stakeholder relationships, and making decisions about adequate and appropriate study compensation. We describe challenges, opportunities, and suggestions for collecting primary data from unhoused older adults. We encourage gerontological researchers not to avoid this hard-to-reach, high-risk population. The lessons learned in designing and implementing studies tailored to the unique challenges of unhoused older adults can promote inclusion of the perspectives and needs this population.

LONELINESS AMONG UNDER-REPRESENTED OLDER ADULTS IN THE UK: A STUDY OF MINORITY ETHNIC AND LGBTQ+ POPULATIONS

Abstract Internationally loneliness has been identified as a major public health problem. Although there is a substantial body of research about loneliness in older adults in the UK, there is a significant evidence gap reporting experiences of loneliness of older people from ethnic minorities and those who identify as lesbian, gay, or bisexual and transgender (LGBT). These two groups, under-represented in UK gerontological research, are included in our recently funded project, Socially Inclusive Ageing across the Lifecourse. In this poster we explicitly focus upon the experiences of loneliness for older adults, aged 50+, from the LGBTQ+ and minority ethnic communities. Using wave 9 data from the UK Household Longitudinal Study (UKHLS/Understanding Society) we measured loneliness using the three-item UCLA scale with a score of 6+ out of 9 defining loneliness. Of our total sample of 16,805 who completed the loneliness measure, 1.5% of respondents identified as LGB and 5.4% as Asian, 2.9% as black and 1.5% as other or mixed ethnicity. Overall, 21.7% of the population aged 50+ were lonely. Participants from a black, Asian or other ethnic minority reported higher loneliness than white respondents: 25.8%, 29.6%, 31.0% and 21.0% respectively. Respondents identifying as gay or lesbian (29.1%) or as bisexual (35.2%) reported greater loneliness in comparison to those who identified as heterosexual (21.3%). Our study is novel and timely in demonstrating the higher prevalence of loneliness in two under-represented groups of older adults with the potential consequences this may have for their health and wellbeing in later life.

WHY DO I CARE? MOTIVATIONS OF SURVIVORS OF PARENTAL CHILDHOOD HARM WHO ARE CARING FOR THEIR PARENTAL PERPETRATOR

Abstract Adult child survivors of parental childhood maltreatment may remain in relationship with their parental perpetrator across the life course and even take on the caregiving role when their parent becomes older and/or ill. Yet, becoming a caregiver for a parent who was harmful is associated with increased depressive symptoms, heightened stress responses, and maladaptive coping for the caregiver. Given that survivors of parental childhood maltreatment may find caregiving to be detrimental to their mental health and well-being, it is crucial to better understand why an adult child would choose to engage in caregiving for their parental perpetrator. This qualitative research, grounded in Intergenerational Solidarity Theory, examines the motivations to participate in parental caregiving through serious illness or the end of life for survivors of childhood parental harm. Based on the phenomenological perspective, in-depth semi-structured interviews were conducted with 22 adults ages 24-70. Participants were recruited through word-of-mouth and social media. Content analysis revealed five themes: 1) obligation and ambivalence; 2) differentiating from the abuser; 3) “a second chance;” 4) belief systems that influence caregiving; and 5) financial incentives. This information heightens awareness of the experiences of this often-overlooked population of caregivers and invites gerontological researchers and practitioners to consider the complexity in their decision to participate in their perpetrator’s care. Gaining a better understanding of the lived experiences of adult children who are caregivers for their parental perpetrator and their motivations for participating in such care can inform the development of trauma-informed assessment and intervention strategies tailored to this population.

AGING ACROSS THE LIFE COURSE: RESEARCH COLLECTIONS AVAILABLE FROM THE NATIONAL ARCHIVE OF COMPUTERIZED DATA ON AGING

Abstract Creating and maintaining sustainable data archives can be challenging but offers clear advantages. Properly curated data can be used by multiple researchers, testing a variety of hypotheses and increasing the return on investment to the expensive data collection process. An internally managed archival system also provides greater control and autonomy in the equitable distribution of data resources. This process ensures all researchers will fully use the data for original research, teaching, and new directions once the data leaves the control of the local investigator. This poster reviews the advantages of a local strategy for preserving and sharing gerontological research data. Using the National Archive of Computerized Data on Aging (NACDA) as a working example, the poster offers an overview of collections at NACDA. Using our metadata tools and variable search database, NACDA can identify studies in its collections that examine aspects of aging and health among adults during their lifecourse. Many of the studies are longitudinal or repeat-measure cross-sectional studies. We can also identify studies that focus on aging not maintained by NACDA that are available to interested researchers. Using a strategy of archival preservation combined with a strong focus on productive research Innovation in Aging, NACDA has amassed data and metadata covering a wide array of studies worldwide that address the aging lifecourse. Because our collections are multinational, we share these data at no cost to interested users worldwide.

PERSONALITY AND WORD RECALL AS INTERACTIVE PREDICTORS OF PERCEIVED MEMORY ABILITY

Abstract Cognitive gerontology research requires consideration of both actual performance and perceptions of performance. While subjective memory perceptions are positively associated with memory performance, these correlations typically are modest in magnitude. Therefore, researchers have noted the need to consider potential moderators of this association, to better understand whether certain people show weaker or stronger linkages between performance and perceptions. The current study leveraged personality (NEO Big Five), memory performance (i.e., word recall), and perceptions of memory ability (i.e., metamemory in adulthood scale and subjective memory complaints) data from the St. Louis Personality and Aging Network (SPAN) study (n = 774, mean age: 71.52 years). Personality traits were more associated with subjective than objective memory, and the most consistent associations were for extraversion (r = -.20 for complaints, r = .26 for metamemory) and conscientiousness (r = -.26 for complaints and r = .33 for metamemory). Moreover, extraversion moderated associations between word recall and both memory capacity and complaints. Results suggested that associations between word recall and the two subjective indicators were weaker for those adults higher in extraversion, relative to adults who scored lower on extraversion. One possible interpretation is that extraverted older adults may construct their cognitive self-perceptions using information from their social interactions more than objective cues. These findings highlight the need to determine how personality traits influence which sources of information older adults employ when thinking about their cognitive ability, which in turn may explain their choices for activity engagement.

IDENTIFYING PREDICTORS OF RESILIENCE IN SINGLE-ARM STUDIES OF PRE–POST CHANGE

Abstract With advancing age, older adults are at a greater risk of experiencing significant stressors. While frailty is the increased vulnerability to stressors, resilience is the ability to respond well to a major stressor. An important goal of geriatric research is to identify factors which influence resilience to stressors. Studies of resilience in older adults are typically conducted using a single-arm design where everyone experiences the stressor. In such designs, resilience is typically quantified as the degree of recovery in physical/cognitive/psychological functions after the stressor. The simplistic approach of regressing change versus baseline yields biased estimates due to mathematical coupling and regression-to-the-mean. Correction is necessary for eliminating the bias and drawing valid inferences regarding the effect of covariates and baseline status on pre-post change. We present a simple method to correct this bias. We extend the method to include covariates. Our approach considers a counterfactual control group and involves sensitivity analyses to evaluate different settings of control group parameters. We illustrate the method using a large, registry of older adults (N=7,239) who underwent total knee replacement (TKR). We demonstrate how external data can be utilized to constrain the sensitivity analysis. Our analysis indicates that baseline (pre-stressor) function was not strongly linked to recovery after TKR. Among the covariates, only age had a consistent effect on post-stressor recovery. A main takeaway of our work is that studies of resilience should consider, either directly or indirectly, the use of an appropriate control group.

METHODOLOGICAL CHALLENGES AND OPPORTUNITIES FOR STUDYING RESILIENCE

Abstract Many older adults experience a major stressor at some point in their lives. The ability to recover and live well after a major stressor is known as resilience. An important goal of geriatric research is to identify factors which influence resilience to stressors, and ultimately, to devise strategies to enhance the resilience of older adults. In order to accomplish these worthy aims, several methodological challenges need to be addressed. Methodologies for studying resilience in clinical settings are only recently being developed. Investigators at Duke, Johns Hopkins, and Radboud Universities are studying cohorts of older individuals who are undergoing invasive clinical procedures using longitudinal designs. These studies collect a vast array of information on each participant including socio-demographics, health status, physical, cognitive, psychological, and biological functions. Also, large amount of experimental data is collected on the dynamics of select physiological systems as probes of resilience (“deep phenotyping”). Deep phenotyping leads to several challenges in the conduct and analysis of the study including selective participation (selection bias), informatively missing data, characterizing resilient responses based upon trajectories of multidimensional measures before and after stressor, modeling dynamical systems experimental data, and quantification of resilience capacity and its determinants. In this symposium, we will discuss some of the critical methodological challenges of studying resilience and present approaches to address them. At the end of this symposium, the audience members should understand the importance of designs and analytic challenges in studying resilience, and become knowledgeable on the approaches to overcome methodological challenges.

Implementation research in geriatrics: an opportunity to build healthy aging

Implementation research in geriatrics: an opportunity to build healthy aging

Application of machine learning in measurement of ageing and geriatric diseases: a systematic review

BackgroundAs the ageing population continues to grow in many countries, the prevalence of geriatric diseases is on the rise. In response, healthcare providers are exploring novel methods to enhance the quality of life for the elderly. Over the last decade, there has been a remarkable surge in the use of machine learning in geriatric diseases and care. Machine learning has emerged as a promising tool for the diagnosis, treatment, and management of these conditions. Hence, our study aims to find out the present state of research in geriatrics and the application of machine learning methods in this area.MethodsThis systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and focused on healthy ageing in individuals aged 45 and above, with a specific emphasis on the diseases that commonly occur during this process. The study mainly focused on three areas, that are machine learning, the geriatric population, and diseases. Peer-reviewed articles were searched in the PubMed and Scopus databases with inclusion criteria of population above 45 years, must have used machine learning methods, and availability of full text. To assess the quality of the studies, Joanna Briggs Institute's (JBI) critical appraisal tool was used.ResultsA total of 70 papers were selected from the 120 identified papers after going through title screening, abstract screening, and reference search. Limited research is available on predicting biological or brain age using deep learning and different supervised machine learning methods. Neurodegenerative disorders were found to be the most researched disease, in which Alzheimer’s disease was focused the most. Among non-communicable diseases, diabetes mellitus, hypertension, cancer, kidney diseases, and cardiovascular diseases were included, and other rare diseases like oral health-related diseases and bone diseases were also explored in some papers. In terms of the application of machine learning, risk prediction was the most common approach. Half of the studies have used supervised machine learning algorithms, among which logistic regression, random forest, XG Boost were frequently used methods. These machine learning methods were applied to a variety of datasets including population-based surveys, hospital records, and digitally traced data.ConclusionThe review identified a wide range of studies that employed machine learning algorithms to analyse various diseases and datasets. While the application of machine learning in geriatrics and care has been well-explored, there is still room for future development, particularly in validating models across diverse populations and utilizing personalized digital datasets for customized patient-centric care in older populations. Further, we suggest a scope of Machine Learning in generating comparable ageing indices such as successful ageing index.

A national survey on health-related quality of life for people with dementia in residential long-term care institutions

BackgroundHealth-related quality of life (HRQoL) is an essential outcome parameter in geriatric research; however, the available evidence is mixed regarding the factors associated with HRQoL among people with dementia. We aimed to identify factors that contribute to HRQoL among people with dementia in residential long-term care (LTC) institutions. MethodsWe randomly selected 299 of 1607 registered residential LTC institutions in Taiwan. A cross-sectional survey was conducted between 2019 and 2020, including items on demographic characteristics, comorbidities, the EuroQol-5 dimensions-5 levels (EQ-5D-5L; utility and visual analog scale [VAS] scores), the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), behavioral and psychological symptoms of dementia, activities of daily living (ADL), and instrumental ADL (IADL). ResultsIn total, 1313 people with dementia from 267 institutions were enrolled (mean age, 76.4 ± 12.7 years). The mean EQ-5D-5L utility and VAS scores were 0.10 (standard deviation [SD] = 0.48) and 66.57 (SD = 20.67), respectively. In multivariate linear regression analysis, higher scores for ADL, IADL, and CDR sum of boxes were associated with higher utility scores. Higher VAS scores were associated with higher ADL and MMSE scores. Lower utility scores and VAS scores were associated with more frequent depressive symptoms. ConclusionADL, dementia severity, cognitive function, and depressive symptoms influenced the HRQoL of people with dementia in residential LTC institutions. Longitudinal studies should be conducted to better understand how HRQoL changes over time among people with disabilities.

Use of Electronic Medical Records (EMR) in Gerontology: Benefits, Considerations and a Promising Future.

Electronic medical records (EMRs) have many benefits in clinical research in gerontology, enabling data analysis, development of prognostic tools and disease risk prediction. EMRs also offer a range of advantages in clinical practice, such as comprehensive medical records, streamlined communication with healthcare providers, remote data access, and rapid retrieval of test results, ultimately leading to increased efficiency, enhanced patient safety, and improved quality of care in gerontology, which includes benefits like reduced medication use and better patient history taking and physical examination assessments. The use of artificial intelligence (AI) and machine learning (ML) approaches on EMRs can further improve disease diagnosis, symptom classification, and support clinical decision-making. However, there are also challenges related to data quality, data entry errors, as well as the ethics and safety of using AI in healthcare. This article discusses the future of EMRs in gerontology and the application of AI and ML in clinical research. Ethical and legal issues surrounding data sharing and the need for healthcare professionals to critically evaluate and integrate these technologies are also emphasized. The article concludes by discussing the challenges related to the use of EMRs in research as well as in their primary intended use, the daily clinical practice.

P26: Self-reported health-related quality of life for people with dementia in long-term care facilities in Taiwan: a nationwide survey

Background:Quality of life is an essential outcome parameter in geriatric research; however, research to date offers mixed evidence about the factors associated with health-related quality of life (HRQOL) among people with dementia (PWDs). We aimed to identify factors relating to HRQOL among PWDs living in long-term care (LTC) facilities.Methods:A total of 299 from 1,607 registered long-term care facilities were randomly selected in every administrative region of Taiwan. A cross-sectional two-phase survey, which included the demographic data, comorbidities, EuroQol-5 dimensions-5 levels (EQ-5D-5L), mini-mental state examination (MMSE) score, clinical dementia rating scores (CDR), behavioral and psychological symptoms of dementia, and activities of daily living (ADL) of PWDs, was then conducted from 2019 to 2020.Results:A total of 1,313 PWDs who self-completed EQ-5D-5L were enrolled in this analysis with a mean age of 76.43 ± 12.7 years. The mean utility and visual analogue scale (VAS) scores of EQ-5D-5L were 0.10 (standard deviation, SD = 0.48) and 66.57 (SD = 20.67), respectively. Multivariate linear regression analysis showed that higher scores in ADL, instrumental ADL, and lower CDR sum scores were associated with higher EQ-5D-5L utility scores. Higher ADL scores and higher MMSE scores were associated with higher scores in an EQ-5D-5L-VAS. More depressive symptoms were related to both lower utility score and lower EQ-5D-5L-VAS score.Conclusion:Findings highlight the importance to recognize and to treat depression to maintain HRQOL of PWDs in LTC facilities. Longitudinal studies are needed to better understand the long-term changes in HRQOL of PWDs.

The role of Department of Veterans Affairs community-based outpatient clinics in enhancing rural access to geriatrics telemedicine specialty care.

Half of the 4.7 M veterans who reside in rural communities and rely on U.S. Department of Veterans Affairs (VA) health care are older (≥65). Their rurality presents unique challenges, including a shortage of clinicians skilled in geriatric medicine. Community-based outpatient clinics (CBOCs) help extend VA's geographic reach but are typically located in under-resourced settings. Telemedicine may increase access to care, but little is known about CBOCs' capacity to leverage telemedicine to meet older patients' needs. We identified organizational barriers and facilitators to the use of geriatric telemedicine specialty care from the perspective of rural clinicians and staff. From February-April 2020, we interviewed CBOC clinicians and staff (N = 50) from 13 rural CBOCs affiliated with four VA Geriatric Research Education and Clinical Centers. Semi-structured interviews addressed patient population characteristics; CBOC location, staffing, and in-house resources; use of VA specialty care services; and telemedicine use. We developed a codebook using an iterative process and Gale's Framework Method thematically organize and analyze data. Respondents perceived that their CBOCs serve a predominantly older patient population. Four characteristics enabled CBOCs to offer geriatric telemedicine specialty care: partnerships with larger VA Medical Center teams; social worker/telehealth clinical technician knowledge of geriatrics and telehealth resources; periodic outreach/education from geriatric specialists; and routine use of other telehealth services. Barriers included: constraints on clinic space and unstable internet for telemedicine visits; staffing challenges leading to limited familiarity with telemedicine resources; and clinician and staff perceptions of older veterans' preference for in-person visits. Telemedicine is an important modality to enhance access to care for an increasingly older and medically complex patient population. Although rural CBOCs provide a large portion of care to VA's growing geriatric population, staff are insufficiently trained in geriatrics, work in resource-poor settings, and are largely unaware of VA telemedicine programs designed to support them.

Mediating effects of depression on sleep disturbance and frailty in older adult type 2 diabetes patients in the community.

With the progressive aging of the population, frailty is now a significant challenge in geriatrics research. A growing amount of evidence suggests that sleep disturbance and depression have independent effects on frailty, although the underlying mechanisms are not yet clear. This study aimed to investigate the mediating role of depression in the relationship between sleep disturbance and frailty in older adult patients with type 2 diabetes (T2DM) in the community. Purposive sampling was used to collect face-to-face data from 342 community-dwelling T2DM patients in Chengdu, Sichuan Province, China, between February and May 2023. The Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate sleep quality, the Simple Geriatric Depression Scale (GDS-15) was used to evaluate depressive symptoms, and the FRAIL Scale (FRAIL) was used to evaluate frailty. Linear regression equation and bootstrap self-sampling were used to verify the mediating role of depressive symptoms in sleep disturbance and frailty. The study found that sleep disturbance had a direct positive effect with frailty [β = 0.040, 95% CI: (0.013, 0.069)]. Additionally, depression had a direct positive effect on frailty [β = 0.130, 95% CI: (0.087, 0.173)], and depression was found to partially mediate the relationship between sleep disturbance and frailty. Poor sleep quality and frailty are common in patients with T2DM. To reduce the frailty of older adult T2DM patients, all levels of society (government, medical institutions, and communities) must pay more attention to mental health. A variety of interventions should be considered to improve sleep quality and depression, which in turn may prevent or control frailty.

Geriatric Oral Health Research: Research Designs and Areas of Research

Geriatric Oral Health Research: Research Designs and Areas of Research

Why freshwater hydra does not get Alzheimer’s disease

The history of research into the basic mechanisms of the pathogenesis of Alzheimer’s disease (AD) is briefly considered. Concepts are analyzed in which a decisive role in the development of this disease was attributed to aluminum or free radicals. The lack of reliable data to date to support these concepts is emphasized. The point of view of the author is presented, according to which almost all the results indicating the feasibility of using antioxidants (as well as other potential drugs for AD) for the prevention and treatment of AD were obtained on model animals with certain pathologies (for example, with severe oxidative stress), which contribute to the formation of symptoms similar to those of AD in humans. In this regard, parallels are drawn with experimental gerontological research aimed at studying the effect of a calorie-restricted diet on aging and life span. It is noted that in these studies, animals were used that were either not completely normal or were in unfavorable conditions. According to the author, the lack of significant progress in the development of effective geroprotectors or drugs for the prevention/ treatment of AD is due to the fact that most specialists ignore the principles of classical gerontology, in particular, the definitions of aging and age-related diseases, as well as the correct approaches to the selection of control objects for their studies. It is emphasized that humans, unfortunately, cannot use the freshwater hydra method to combat aging and age-related diseases. Under certain conditions, it continuously renews all cells (including nerve ones) of its body and thereby ensures its “immortality.” In humans, the replacement of “old” neurons can lead to the loss of personality/individuality, and the “repair” of these cells today seems impossible. In this regard, the author considers it expedient to study the aging of postmitotic cells in experiments on stationary cell cultures, which can accelerate, in particular, the deciphering of the mechanisms of accumulation of beta-amyloid and senile pigments such as lipofuscin in neurons. The need for clinical studies of AD is noted as complementary to experimental work, although the first ones are much more expensive and time-consuming. Only confirmation in human studies of the effectiveness of drugs developed in experiments on model animals will allow them to be recommended for use in the clinical practice.